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30-10-2013

A once-eradicated virus has sickened at least 10 children and babies in war-torn Syria, according to United Nations officials tracking the outbreak.

Reports of acute flaccid paralysis – a telltale sign of polio – began to surface earlier this month in the country’s heavily contested Deir Al Zour province. Tests have now confirmed the infection in 10 of 22 suspected cases, most of which involve children aged 2 years or younger, according to a World Health Organization spokesman Oliver Rosenbauer.

“We will run an outbreak response immunization program, not just in the affected area but right across Syria and in seven neighboring countries,” said Rosenbauer, describing a six-month emergency vaccination effort aimed at protecting under-immunized children.

On 17 October 2013, WHO received reports of a cluster of acute flaccid paralysis (AFP) cases in the Syrian Arab Republic. This cluster of ‘hot’ AFP was detected in early October 2013 in Deir Al Zour province and is currently being investigated. Initial results from the national polio laboratory in Damascus indicate that two of the cases could be positive for polio – final results are awaited from the regional reference laboratory of the Eastern Mediterranean Region of WHO. Wild poliovirus was last reported in Syria in 1999.

The Ministry of Health of the Syrian Arab Republic confirms that it is treating this event as a cluster of ‘hot’ AFP cases, pending final laboratory confirmation, and an urgent response is currently being planned across the country. Syria is considered at high-risk for polio and other vaccine-preventable diseases due to the current situation.

A surveillance alert has been issued for the region to actively search for additional potential cases. Supplementary immunization activities in neighbouring countries are currently being planned.

WHO’s International Travel and Health recommends that all travelers to and from polio-infected areas be fully vaccinated against polio.

Polio was last seen in Syria in 1999, but the civil war has hindered vaccination efforts. And because the virus is endemic in Nigeria, Pakistan and Afghanistan, it can easily be imported, according to Dr. William Schaffner, an infectious disease expert and chair of prevention at Vanderbilt University Medical Center in Nashville, Tenn.

“People who carry the virus in their intestinal tracts can transmit it, either person-to-person or through contaminated water systems,” said Schaffner, explaining how polio lives in the gut but can invade the blood stream and attack the spinal cord to cause permanent paralysis in one of every 200 people infected.

“The treatment, unfortunately, is entirely symptomatic,” said Schaffner, noting that the virus usually causes paralysis on one side of the body. “You care for the patient until the infection runs its course. We don’t have an antiviral treatment for polio.”

Schaffner said the possibility of polio in Syria is tragic, but not unexpected.